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Singh M, Balmaceno-Criss M, Anderson G, Parhar K, Daher M, Gregorczyk J, Liu J, McDonald CL, Diebo BG, Daniels AH. Anterior cervical discectomy and fusion versus cervical disc arthroplasty: an epidemiological review of 433,660 surgical patients from 2011 to 2021. Spine J 2024; 24:1342-1351. [PMID: 38408519 DOI: 10.1016/j.spinee.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/06/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND CONTEXT Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are commonly performed operations to address cervical radiculopathy and myelopathy. Trends in utilization and revision surgery rates warrant investigation. PURPOSE To explore the epidemiology, postoperative complications, and reoperation rates of ACDF and CDA. DESIGN Retrospective cohort study. PATIENT SAMPLE A total of 433,660 patients who underwent ACDF or CDA between 2011 and 2021 were included in this study. OUTCOME MEASURES The following data were observed for all cases: patient demographics, complications, and revisions. METHODS The PearlDiver database was queried to identify patients who underwent ACDF and CDA between 2011 and 2021. Epidemiological analyses were performed to examine trends in cervical procedure utilization by age group and year. After matching by age, sex, Charlson Comorbidity Index (CCI), levels of operation, and reason for surgery, the early postoperative (2-week), short-term (2-year), and long-term (5-year) complications of both cervical procedures were examined. RESULTS In total, 404,195 ACDF and 29,465 CDA patients were included. ACDF utilization rose by 25.25% between 2011 and 2014 while CDA utilization rose by 654.24% between 2011-2019 followed by relative plateauing in both procedures. Mann-Kendall trend test confirmed a significant but small rise in ACDF and large rise in CDA procedures from 2011 to 2021 (p<.001). After matching, ACDF and CDA had an overall complication rate of 12.20% and 8.77%, respectively, with the most common complications being subsequent anterior revision (4.96% and 3.35%) and dysphagia (3.70% and 2.98%). The ACDF cohort, especially multilevel ACDF patients, generally had more complications and higher revision rates than the CDA cohort (p<.05). CONCLUSIONS While ACDF utilization has plateaued since 2014, CDA rates have risen by a staggering 654.24% over the past decade. ACDF and CDA complication and revision rates were relatively low in comparison to previously published values, with significantly lower rates in CDA. Although a lack of radiographic data in this study limits its power to recommend either procedure for individual patients with cervical radiculopathy or myelopathy, CDA may be associated with minor improvement in the complication and revision profile.
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Affiliation(s)
- Manjot Singh
- Warren Alpert Medical School of Brown University, 222 Richmond St., Providence, RI 02903, USA
| | - Mariah Balmaceno-Criss
- Warren Alpert Medical School of Brown University, 222 Richmond St., Providence, RI 02903, USA; Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - George Anderson
- Warren Alpert Medical School of Brown University, 222 Richmond St., Providence, RI 02903, USA
| | - Kanwar Parhar
- Elson S. Floyd College of Medicine, Washington State University, 412 E Spokane Falls Blvd, Spokane, WA 99202, USA
| | - Mohammad Daher
- Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - Jerzy Gregorczyk
- Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - Jonathan Liu
- Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - Christopher L McDonald
- Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - Bassel G Diebo
- Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - Alan H Daniels
- Department of Orthopedics, Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA.
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Kouser V H, Nayab M, Ansari AN, Mir MA, Anwar M. Efficacy of wet cupping in the pain management of cervical spondylosis - A randomized, controlled, open -label, parallel-group clinical trial. J Bodyw Mov Ther 2024; 39:126-131. [PMID: 38876616 DOI: 10.1016/j.jbmt.2024.02.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 11/27/2023] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND AND OBJECTIVE Cervical spondylosis is a chronic degenerative process of the cervical spine characterized by pain in neck, degenerative changes in intervertebral disc and osteophyte formation. Cervical spondylosis is translated as Waja' ur Raqaba, a type of joint pain. The present study was aimed to evaluate the effect of wet cupping in the pain management of cervical spondylosis. METHODS This Open, randomized, controlled, clinical study was conducted on 44 patients. Subjects in the test group (n = 22) received a series of three-staged wet cupping treatment, performed on 0, 7th and 14th day. Subjects in the control group (n = 22) received 12 sittings of Transcutaneous Electrical Nerve Stimulation (TENS): 6 sittings per week for two weeks. The objective findings of treatment were assessed with the help of VAS, Neck Disability Index (NDI) and Cervical range of motion. RESULTS Intra group comparison in test group from baseline to 21st day were found highly significant (p < 0.001) in terms of VAS, NDI, Flexion, Extension and Left rotation score. While in Right rotation, Left rotation and Left lateral flexion score were found moderately significant (p < 0.01). Statistically significant difference was observed between two groups at 21st day in VAS scale, NDI, and Cervical range of motion score (p < 0.001). INTERPRETATION AND CONCLUSION Ḥijāma Bish Sharṭ was found better in the management of pain due to cervical spondylosis than TENS. It can be concluded that Ḥijāma Bish Sharṭ may a better option for the pain management of cervical spondylosis. CLINICAL TRIAL REGISTRATION The trial was registered on clinical trial registry website (www.ctri.nic.in) bearing a CTRI Number, CTRI/2020/03/024,249.
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Affiliation(s)
- Hina Kouser V
- PG Scholar, Dept. of Ilaj Bit Tadbeer, NIUM, Bengaluru, India
| | - Mohd Nayab
- Assistant Professor, Dept. of Ilaj Bit Tadbeer, NIUM, Bengaluru, India.
| | | | - Manzoor Ahmad Mir
- Medical Officer, Government Health Services, Jammu and Kashmir, India
| | - Mohd Anwar
- Professor & Chairman, Dept. of Ilaj Bit Tadbeer, AKTC, AMU, Aligarh, India
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Wang Y, Zhang Y, Zhao C, Yang H, Ai C, Zhao W, Xu J. Genetic link between depression and musculoskeletal disorders: insights from Mendelian randomization analysis. Front Med (Lausanne) 2024; 11:1398203. [PMID: 38882662 PMCID: PMC11177873 DOI: 10.3389/fmed.2024.1398203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
Background The association between depression and musculoskeletal diseases has long been a subject of contentious debate. However, the causal relationship between the two remains uncertain. This study employs a two-sample Mendelian randomization (MR) analysis to investigate the causality between depression and six musculoskeletal diseases. Methods In this study, we performed MR analysis to systematically explore the causal relationship between depression and six musculoskeletal disorders. Single nucleotide polymorphisms (SNPs) that are linked to depression were employed as instrumental variables. To ensure robust and reliable conclusions, multiple analytical approaches were utilized, including inverse variance weighting(IVW), weighted median, and MR-Egger regression. Additionally, sensitivity analysis methods such as the MR-Egger intercept test, Cochran's Q test, leave-one-out analysis, and funnel plot were employed. Results Our MR analysis revealed a significant association between depression and cervical spondylosis (depression: OR 1.003, 95% CI 1.002-1.005, P = 8.32E-05; major depressive disorder: OR 1.003, 95% CI 1.001-1.005, P = 0.0052). Furthermore, a strong correlation was noted between major depressive disorder (MDD) and knee osteoarthritis (KOA) (OR 1.299, 95% CI 1.154-1.463, P = 1.50E-5). Sensitivity analysis confirmed the robustness of these findings. Our independent validation study also corroborated these results. Conclusion The MR analysis conducted in this study provides evidence supporting a genetic link between depression and cervical spondylosis, as well as KOA. Targeted interventions to manage depression in susceptible populations may contribute to lowering the risk of cervical spondylosis and KOA in these cohorts.
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Affiliation(s)
- Yanpeng Wang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Yinzhen Zhang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Changwei Zhao
- Department of Orthopedics, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Hao Yang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Chenglong Ai
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Wenhai Zhao
- Department of Orthopedics, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Ji Xu
- Department of Spinal Orthopedics, Weifang Hospital of Traditional Chinese Medicine, Shandong Second Medical University, Weifang, China
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Yan S, Xie LY, Duan XX, Tan JX, Yang S, Meng L, Zhong QH, Lin WD, Yang JN, Xiao YY, Jiang X. Electroacupuncture improves apoptosis of nucleus pulposus cells via the IL-22/JAK2-STAT3 signaling pathway in a rat model of cervical intervertebral disk degeneration. Acupunct Med 2024:9645284241248465. [PMID: 38702866 DOI: 10.1177/09645284241248465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
BACKGROUND Cervical spondylosis (CS) is a prevalent disorder that can have a major negative impact on quality of life. Traditional conservative treatment has limited efficacy, and electroacupuncture (EA) is a novel treatment option. We investigated the application and molecular mechanism of EA treatment in a rat model of cervical intervertebral disk degeneration (CIDD). METHODS The CIDD rat model was established, following which rats in the electroacupuncture (EA) group received EA. For overexpression of IL-22 or inhibition of JAK2-STAT3 signaling, the rats were injected intraperitoneally with recombinant IL-22 protein (p-IL-22) or the JAK2-STAT3 (Janus kinase 2-signal transducer and activator of transcription protein 3) inhibitor AG490 after model establishment. Rat nucleus pulposus (NP) cells were isolated and cultured. Cell counting kit-8 and flow cytometry were used to analyze the viability and apoptosis of the NP cells. Expression of IL-22, JAK2 and STAT3 was determined using RT-qPCR. Expression of IL-22/JAK2-STAT3 pathway and apoptosis related proteins was detected by Western blotting (WB). RESULTS EA protected the NP tissues of CIDD rats by regulating the IL-22/JAK2-STAT3 pathway. Overexpression of IL-22 significantly promoted the expression of tumor necrosis factor (TNF)-α, IL-6, IL-1β, matrix metalloproteinase (MMP)3 and MMP13 compared with the EA group. WB demonstrated that the expression of IL-22, p-JAK2, p-STAT3, caspase-3 and Bax in NP cells of the EA group was significantly reduced and Bcl-2 elevated compared with the model group. EA regulated cytokines and MMP through activation of IL-22/JAK2-STAT3 signaling in CIDD rat NP cells. CONCLUSION We demonstrated that EA affected apoptosis by regulating the IL-22/JAK2-STAT3 pathway in NP cells and reducing inflammatory factors in the CIDD rat model. The results extend our knowledge of the mechanisms of action underlying the effects of EA as a potential treatment approach for CS in clinical practice.
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Affiliation(s)
- Sen Yan
- Acupuncture Department II, Yueyang Hospital of Traditional Chinese Medicine, Yueyang, China
| | - Ling-Yao Xie
- Acupuncture Department II, Yueyang Hospital of Traditional Chinese Medicine, Yueyang, China
| | - Xia-Xia Duan
- Acupuncture Department II, Yueyang Hospital of Traditional Chinese Medicine, Yueyang, China
| | - Jia-Xuan Tan
- Acupuncture Department II, Yueyang Hospital of Traditional Chinese Medicine, Yueyang, China
| | - Song Yang
- Acupuncture Department II, Yueyang Hospital of Traditional Chinese Medicine, Yueyang, China
| | - Ling Meng
- Acupuncture Department II, Yueyang Hospital of Traditional Chinese Medicine, Yueyang, China
| | - Qing-Hua Zhong
- Acupuncture Department II, Yueyang Hospital of Traditional Chinese Medicine, Yueyang, China
| | - Wei-Di Lin
- Acupuncture Department II, Yueyang Hospital of Traditional Chinese Medicine, Yueyang, China
| | - Jia-Ni Yang
- Acupuncture Department II, Yueyang Hospital of Traditional Chinese Medicine, Yueyang, China
| | - Yao-Yao Xiao
- Acupuncture Department II, Yueyang Hospital of Traditional Chinese Medicine, Yueyang, China
| | - Xueyu Jiang
- Acupuncture Department II, Yueyang Hospital of Traditional Chinese Medicine, Yueyang, China
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Ren Z, Cheng X, Xu J, Niu T, Long H. Causal associations of cognition, intelligence, education, health and lifestyle factors with cervical spondylosis: a mendelian randomization study. Front Genet 2024; 15:1297213. [PMID: 38725482 PMCID: PMC11079178 DOI: 10.3389/fgene.2024.1297213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/19/2024] [Indexed: 05/12/2024] Open
Abstract
Background: Education, cognition, and intelligence are phenotypically and genetically related. Education has been shown to have a protective effect on the risk of developing cervical spondylosis. However, it is unclear whether cognition and intelligence have independent causal effects on cervical spondylosis, and whether health and lifestyle factors influence this association. Methods: We first assessed the independent effects of education, cognition, and intelligence on cervical spondylosis by two-sample Mendelian randomization and multivariable Mendelian randomization analysis, and evaluated 26 potential association mediators using two-step Mendelian randomization, and calculated the median proportion. Results: The results showed that only education had an independent causal effect on cervical spondylosis, and had a protective effect on the risk of cervical spondylosis (β: 0.3395; se: 0.166; p < 0.05; OR:0.71; [95%CI: 0.481-0.943]. Of the 26 potential associated mediators, a factor was identified: SHBG (mediated proportion: 2.5%). Univariable Mendelian randomization results showed that the risk factors for cervical spondylosis were time spent watching TV (OR:1.96; [95%CI: 1.39-2.76]), smoking (OR:2.56; [95%CI: 1.061-1.486]), body mass index (OR:1.26; [95%CI: 1.124-1.418]), percentage of body fat (OR:1.32; [95%CI: 1.097-1.593]), major depression (OR:1.27; [95%CI: 1.017-1.587]) and sitting height (OR:1.15; [95%CI: 1.025-1.291]). Protective factors include computer using (OR:0.65; [95%CI: 0.418-0.995]), sex hormone binding globulin (OR:0.87; [95%CI: 0.7955-0.951]) and high-density lipoprotein (OR:0.90; [95%CI: 0.826-0.990]). Conclusion: Our findings demonstrate the causal and independent effects of education on cervical spondylosis and suggest that lifestyle media may be a priority target for the prevention of cervical spondylosis due to low educational attainment.
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Affiliation(s)
- Zhenxiao Ren
- Department of Spine Surgery, Orthopaedic, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University/The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong Province, China
- Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology/Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Xing Cheng
- Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology/Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
- Department of Spine Surgery, Orthopedics Center of Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jinghui Xu
- Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology/Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Tianzuo Niu
- Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology/Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Houqing Long
- Department of Spine Surgery, Orthopaedic, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University/The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong Province, China
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Wang X, Jin Z, Feng T, Fang S, Sun C, Qin X, Sun K, Liang L, Liu G, Zhu L, Wei X. The immediate effect of cervical rotation-traction manipulation on cervical paravertebral soft tissue: a study using soft tissue tension cloud chart technology. BMC Musculoskelet Disord 2024; 25:184. [PMID: 38424580 PMCID: PMC10903149 DOI: 10.1186/s12891-024-07277-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 02/12/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND To evaluate the reliability of the Soft Tissue Tension Cloud Chart (STTCC) technology, an original method combining multi-point Cervical Paravertebral Soft Tissue Test (CPSTT) with MATLAB software, we conducted a preliminary analysis on the immediate effects of Orthopaedic Manual Therapy (OMT) on cervical paravertebral soft tissue. METHODS 30 patients with Cervical Spondylotic Radiculopathy (CSR) were included in this study. We analyzed the differences in CPSTT before and after treatment with Cervical Rotation-Traction Manipulation (CRTM), a representative OMT technique in Traditional Chinese Medicine, using the STTCC technology. RESULTS The STTCC results demonstrated that post-treatment CPSTT levels in CSR patients were significantly lower than pre-treatment levels after application of CRTM, with a statistically significant difference (P < 0.001). Additionally, pre-treatment CPSTT levels on the symptomatic side (with radicular pain or numbness) were higher across the C5 to C7 vertebrae compared to the asymptomatic side (without symptoms) (P < 0.001). However, this difference disappeared after CRTM treatment (P = 0.231). CONCLUSIONS The STTCC technology represents a reliable method for analyzing the immediate effects of OMT. CSR patients display uneven distribution of CPSTT characterized by higher tension on the symptomatic side. CRTM not only reduces overall cervical soft tissue tension in CSR patients, but can also balance the asymmetrical tension between the symptomatic and asymptomatic sides. TRIAL REGISTRATION This study was approved by the Chinese Clinical Trials Registry (Website: . https://www.chictr.org.cn .) on 20/04/2021 and the Registration Number is ChiCTR2100045648.
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Affiliation(s)
- Xu Wang
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zikai Jin
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Tianxiao Feng
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Shengjie Fang
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Liaocheng Hospital of Chinese Medicine, Liaocheng, Shandong, People's Republic of China
| | - Chuanrui Sun
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaokuan Qin
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Kai Sun
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing Key Laboratory of Traditional Chinese Orthopedics and Traumatology, Beijing, People's Republic of China
| | - Long Liang
- Anhui Provincial Hospital of Chinese Medicine, Hefei, Anhui, People's Republic of China
| | - Guangwei Liu
- Beijing Key Laboratory of Traditional Chinese Orthopedics and Traumatology, Beijing, People's Republic of China
| | - Liguo Zhu
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing Key Laboratory of Traditional Chinese Orthopedics and Traumatology, Beijing, People's Republic of China
| | - Xu Wei
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
- Beijing Key Laboratory of Traditional Chinese Orthopedics and Traumatology, Beijing, People's Republic of China.
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Liu CC, Chen IT, Weng SF. Increased risk of sudden sensorineural hearing loss in patients with cervical spondylosis. Sci Rep 2024; 14:2910. [PMID: 38316838 PMCID: PMC10844319 DOI: 10.1038/s41598-024-52875-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
Whether cervical spondylosis (CS) is a risk factor for sudden sensorineural hearing loss (SSNHL) remains unclear. This study used national population-based data to investigate the risk of SSNHL in patients with CS in Taiwan of different ages and sexes. This study used data covering 2 million people in Taiwan, which were obtained from the National Health Insurance Research Database. The data that support the findings of this study are available from National Health Insurance Research Database but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the corresponding authors upon reasonable request and with permission of National Health Insurance Research Database. This retrospective cohort study enrolled 91,587 patients with a newly diagnosed CS between January 2000 and December 2018. Case and control cohorts were matched 1:1 according to age, sex, and comorbidities. SSNHL incidence rate and risk were compared between the groups. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). The mean follow-up period was 8.80 (SD = 4.12) and 8.24 (SD = 4.09) years in the CS and control cohorts, respectively. The incidence rate of SSNHL in the CS cohort (85.28 per 100 000 person-years) was 1.49-fold significantly higher than that in the non-CS cohort (57.13 per 100,000 person-years) (95% CI 1.32-1.68, P < .001). After age, sex, and selected comorbidities were adjusted for, CS exhibited an independent risk factor for SSNHL (adjusted HR = 1.52; 95% CI 1.34-1.71, P < .001). An age-stratified analysis in this study demonstrated a strong and highly significant association between CS and SSNHL in patients aged < 35 years (IRR = 2.28, 95% CI 1.18-4.39, P = .013). This large-scale Taiwanese-population-based retrospective study found that CS was associated with an increased risk of SSNHL. Acute hearing loss in patients with CS, particularly at a young age, should be carefully evaluated, and prompt treatment for SSNHL should be initiated.
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Affiliation(s)
- Chia-Chun Liu
- Department of Otorhinolaryngology, Yuan's General Hospital, Kaohsiung, Taiwan
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, 100, Shin-Chuan 1st Road, San Ming District, Kaohsiung, 80708, Taiwan
| | - I-Te Chen
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, 100, Shin-Chuan 1st Road, San Ming District, Kaohsiung, 80708, Taiwan
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, 100, Shin-Chuan 1st Road, San Ming District, Kaohsiung, 80708, Taiwan.
- Center for Medical Informatics and Statistics, Office of R&D, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Ling J, Thirumavalavan J, Shin C, Lee TM, Marco RAW, Hirase T. Postoperative Rehabilitation to Improve Outcomes After Cervical Spine Fusion for Degenerative Cervical Spondylosis: A Systematic Review. Cureus 2023; 15:e39081. [PMID: 37332472 PMCID: PMC10269395 DOI: 10.7759/cureus.39081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Postoperative rehabilitation has recently been identified as a high-priority research topic for improving surgical outcomes for degenerative cervical spondylosis (DCS). However, there remains no consensus on specific rehabilitation strategies. Thus, the objective of this study was to evaluate the effectiveness of postoperative rehabilitation strategies for short-term and long-term outcomes after cervical spine fusion for DCS. A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines using the PubMed, Scopus, and Ovid Medline databases. All level I-IV therapeutic studies in the English language investigating the outcomes of postoperative rehabilitation strategies after cervical spine fusion for DCS were included. Nine studies with 895 patients with DCS (747 anterior-only fusion, 55 patients with posterior-only fusion, 93 patients with physiotherapy alone) were included in this analysis, with 446 (49.8%) patients receiving physiotherapy alone or standard postoperative therapy and 449 (50.2%) patients receiving standard postoperative therapy with additional intervention or augmentation. These interventions included pulsed electromagnetic field (PEMF) stimulation, telephone-supported home exercise program (HEP), early cervical spine stabilizer training, structured postoperative therapy, and a postoperative cervical collar. One level II study demonstrated that PEMF led to increased fusion rates at six months postoperatively compared to standard therapy alone, one level II study demonstrated that postoperative cervical therapy in addition to standard therapy was better than standard therapy alone in the improvement of neck pain intensity, one level IV study demonstrated home exercise therapy led to an improvement in neck pain, arm pain, and disability, and six level II studies reported no difference in clinical outcome measures between augmented or targeted therapy and standard postoperative therapy for DCS. In conclusion, there is moderate evidence to suggest that there is no significant difference in clinical and surgical outcomes between standard postoperative therapy and augmented or targeted postoperative therapy for cervical fusion in the setting of cervical spondylosis. However, there is some evidence to support that certain therapeutic modalities, such as PEMF stimulation, may lead to improved fusion rates, clinical outcomes, and patient satisfaction when compared to standard postoperative therapy protocols. There is no evidence to support a difference in effectiveness with different types of postoperative rehabilitation strategies between anterior and posterior fusions for DCS.
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Affiliation(s)
- Jeremiah Ling
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
| | | | - Caleb Shin
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
| | - Tiffany M Lee
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
| | - Rex A W Marco
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
| | - Takashi Hirase
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, USA
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McKee C, Espey R, O'Halloran A, Curran A, Darwish N. A Retrospective Evaluation and Review of Radiographic Outcomes for Anterior Cervical Discectomy and Fusion (ACDF) Procedures: Northern Ireland's Experience. Cureus 2023; 15:e38864. [PMID: 37205174 PMCID: PMC10188236 DOI: 10.7759/cureus.38864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction Anterior Cervical Discectomy and Fusion (ACDF) is the gold standard treatment for symptomatic cervical spondylosis refractory to analgesic medical management. Currently, there are numerous approaches and devices used; however, there is no single implant that is preferred for this procedure. The aim of this study is to evaluate the radiological outcomes of ACDF procedures performed in the regional spinal surgery centre in Northern Ireland. The results of this study will aid surgical decision-making, specifically with regard to the choice of implant. The implants that will be assessed in this study are the stand-alone polyetheretherketone (PEEK) cage (Cage) and the Zero-profile augmented screw implant (Z-P). Methods A total of 420 ACDF cases were reviewed retrospectively. Following exclusion and inclusion criteria, 233 cases were reviewed. In the Z-P group, there were 117 patients, with 116 in the Cage group. Radiographic assessment was carried out at the pre-operative stage, day one post-operation, and follow-up (> three months). Measured parameters included segmental disc height, segmental Cobb angle, and spondylolisthesis displacement distance. Results Patient characteristic features showed no significant difference between the two groups (p>0.05) and no significant difference in mean follow-up time (p=0.146). The Z-P implant was superior in increasing and maintaining disc height post-operatively (+0.4±0.94mm, 5.20±0.66mm) compared to the Cage (+0.1±1.00mm, 4.40±0.95mm) (p<0.001). Z-P was also more successful in restoring and maintaining cervical lordosis in comparison to the Cage group, as it had a significantly smaller kyphosis incidence (0.85% vs. 34.5%) at follow-up (p<0.001). Conclusions Results of this study show a more advantageous outcome in the Zero-profile group as it restores and maintains both disc height and cervical lordosis; it is also more successful in treating spondylolisthesis. This study advocates cautious endorsement of the use of the Zero-profile implant in ACDF procedures for symptomatic cervical disc disease.
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Affiliation(s)
- Christopher McKee
- Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, GBR
| | - Robert Espey
- Orthopaedic Surgery, Belfast Health and Social Care Trust, Belfast, GBR
| | - Amanda O'Halloran
- Orthopaedic Surgery, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Adrian Curran
- Orthopaedic Surgery, Belfast Health and Social Care Trust, Belfast, GBR
| | - Nagy Darwish
- Orthopaedic Surgery, Belfast Health and Social Care Trust, Belfast, GBR
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Mirzamohammadi E, Qasemian N, Kassiri N, Mohammadi S, Hatam J, Ghandhari H. Return-to-Work Status Following One- and Two-Level Anterior Cervical Discectomy and Fusions: A Prospective Cohort Study. Cureus 2022; 14:e27546. [PMID: 36059299 PMCID: PMC9428615 DOI: 10.7759/cureus.27546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2022] [Indexed: 11/05/2022] Open
Abstract
Background: The purpose of this article was to determine the rate of return to work (RTW) and contributing factors after a one- and two-level anterior cervical discectomy and fusion (ACDF), a common spine surgery. Recognizing the contributing factors to RTW of occupationally active patients is important. Methodology: In this study, 68 patients were examined at three, six, and nine months after ACDF by the same team and same spinal surgeon at a single medical center, and the rate of RTW and contributing factors were determined. In this study, relationships were analyzed by the logistic regression method. Results: The results of this study demonstrated that 77.9%, 82.4%, and 82.4% of workers had returned to work after three, six, and nine months, respectively. At nine months, 82.4% of the patients had returned to work, 19.6% returned to part-time work, and 80.4% had returned to their previous work. Conversely, 17.6% of the patients had not returned to work after nine months. In the logistic regression analysis, older age, longer absence from work before surgery, and less employer support were the related factors for no RTW. Conclusions: Per the results, it may be concluded that nearly 82% of patients with ACDF had returned to work after nine months of follow-up. Lack of RTW is affected by older age, longer absence from work before surgery, and employer support. Planning according to these variables can reduce the burden of the problem.
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11
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Swanson BT, Creighton D. Cervical disc degeneration: important considerations for the manual therapist. J Man Manip Ther 2021; 30:139-153. [PMID: 34821212 DOI: 10.1080/10669817.2021.2000089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Cervical disc degeneration (CDD) is a progressive, age-related occurrence that is frequently associated with neck pain and radiculopathy. Consistent with the majority of published clinical practice guidelines (CPG) for neck pain, the 2017 American Physical Therapy Association Neck Pain CPG recommends cervical manipulation as an intervention to address acute, subacute, and chronic symptoms in the 'Neck Pain With Mobility Deficits' category as well for individuals with 'Chronic Neck Pain With Radiating Pain'. While CPGs are evidence-informed statements intended to help optimize care while considering the relative risks and benefits, these guidelines generally do not discuss the mechanical consequences of underlying cervical pathology nor do they recommend specific manipulation techniques, with selection left to the practitioner's discretion. From a biomechanical perspective, disc degeneration represents the loss of structural integrity/failure of the intervertebral disc. The sequelae of CDD include posterior neck pain, segmental hypermobility/instability, radicular symptoms, myelopathic disturbance, and potential vascular compromise. In this narrative review, we consider the mechanical, neurological, and vascular consequences of CDD, including information on the anatomy of the cervical disc and the mechanics of discogenic instability, the anatomic and mechanical basis of radiculitis, radiculopathy, changes to the intervertebral foramen, the importance of Modic changes, and the effect of spondylotic hypertrophy on the central spinal canal, spinal cord, and vertebral artery. The pathoanatomical and biomechanical consequences of CDD are discussed, along with suggestions which may enhance patient safety.
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Affiliation(s)
- Brian T Swanson
- Department of Rehabilitation Sciences University of Hartford, West Hartford, CT, USA
| | - Douglas Creighton
- Human Movement Science Department Oakland University, Rochester, MI, USA
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12
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Risk Factors for Recurrence of Benign Paroxysmal Positional Vertigo. A Clinical Review. J Clin Med 2021; 10:jcm10194372. [PMID: 34640391 PMCID: PMC8509726 DOI: 10.3390/jcm10194372] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/17/2021] [Accepted: 09/23/2021] [Indexed: 12/04/2022] Open
Abstract
Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular dysfunctions encountered in clinical practice. Although the treatment of BPPV is relatively successful, many patients develop recurrence after treatment. Our purpose is to evaluate the mean recurrence rate and risk factors of BPPV after treatment. A review of the literature on the risk factors of BPPV recurrence was performed. A thorough search was conducted using electronic databases, namely Pubmed, CINAHL, Academic Search Complete and Scopus for studies published from 2000 to 2020. Thirty studies were included in this review with 13,358 participants. The recurrence rate of BPPV ranged from 13.7% to 48% for studies with follow-up <1 year, and from 13.3% to 65% for studies with follow-up ≥2 years. Pathophysiologic mechanisms and implication of each of the following risk factors in the recurrence of BPPV were described: advanced age, female gender, Meniere’s disease, trauma, osteopenia or osteoporosis, vitamin D deficiency, diabetes mellitus, hypertension, hyperlipidemia, cardiovascular disease, migraine, bilateral/multicanal BPPV, cervical osteoarthrosis and sleep disorders. Patients with hyperlipidemia and hypertension had the highest recurrence rates of BPPV, 67.80% and 55.89%, respectively, indicating that vascular comorbidities increase the risk of BPPV recurrence. In addition, more than half of patients (53.48%) with diabetes mellitus and BPPV experienced recurrence of BPPV. Knowledge and awareness of risk factors for recurrence of BPPV are essential for the assessment and long-term prognosis of patients. Identification of these relapse risk factors may enhance the ability of clinicians to accurately counsel patients regarding BPPV and associated comorbidities.
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13
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Tan M, Song J, Wang Y, Gong L, Sun Y, Yi P, Yang F, Tang X, Hao Q, Li W. The ratio of the posterior atlanto-occipital interval (PAOI): a novel radiographic ratio method evaluating the risk of cervical spondylotic myelopathy-a case-control study. Quant Imaging Med Surg 2021; 11:3018-3028. [PMID: 34249631 DOI: 10.21037/qims-20-986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 03/12/2021] [Indexed: 12/29/2022]
Abstract
Background Our study aims to introduce a dynamic interval ratio method calculated using cervical hyperextension-flexion X-ray films. Secondarily, we aim to evaluate the relationship between the posterior atlanto-occipital interval ratio and cervical spondylotic myelopathy and explain the rationale. Methods We reviewed 83 cases with visible cervical dynamic X-ray films in our hospital from February 2015 to December 2018. Cases were divided into 2 groups according to their diagnosis (with or without spondylotic myelopathy). Radiographic measurements included the shortest distance between the posterior arch of the atlas and the occipital bone and cervical range of motion, and demographic data such as gender, age, and body mass index were also extracted. The posterior atlanto-occipital interval ratio (distance at hyperextension position/distance at hyperflexion position) was determined using logistic regression analysis models between the 2 groups. Results We included 40 cases in the disease group and 43 cases in the control group. The mean posterior atlanto-occipital interval ratio was 0.65±0.30 (mean ± standard deviation) in the disease group and 0.30±0.28 in the control group, with a significant difference (P<0.01). There was no correlation between the posterior atlanto-occipital interval ratio and gender or body mass index. However, the interval ratio had strong correlations with age, cervical spondylotic myelopathy, and Japanese Orthopaedic Association scores. Age, posterior atlanto-occipital interval ratio, and interval distance at hyperextension in the disease group were higher than those of the control group. Contrastingly, range of motion, Japanese Orthopaedic Association scores, and interval distance at the disease group's hyperflexion position were lower than in the control group. In all cases, the risk of cervical spondylotic myelopathy in the T2 group (cases with middle posterior atlanto-occipital interval ratio, according to the tertiles) was 6 times more than the T1 group (cases with lower ratio), and the T3 group (cases with higher ratio) had a 26.4 times greater risk than the T1 group. Conclusions Our results suggest that the posterior atlanto-occipital interval ratio is a simple and meaningful parameter that could provide prognostic value for the risk of cervical spondylotic myelopathy through the imaging examinations of the selected cases. Higher posterior atlanto-occipital interval ratios indicate a greater risk for cervical spondylotic myelopathy and cervical musculoskeletal dysfunction. A higher posterior atlanto-occipital interval ratio may manifest undetected posterior atlanto-occipital stiffness, which needs more pathological evidence in future studies.
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Affiliation(s)
- Mingsheng Tan
- Graduate School of Peking Union Medical College, Beijing, China.,Orthopedics Department, China-Japan Friendship Hospital, Beijing, China
| | - Jipeng Song
- Graduate School of Peking Union Medical College, Beijing, China.,Orthopedics Department, China-Japan Friendship Hospital, Beijing, China
| | - Yanlei Wang
- Orthopedics Department, China-Japan Friendship Hospital, Beijing, China.,Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Long Gong
- Graduate School of Peking Union Medical College, Beijing, China.,Orthopedics Department, China-Japan Friendship Hospital, Beijing, China
| | - Yan Sun
- Orthopedics Department, China-Japan Friendship Hospital, Beijing, China.,Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Ping Yi
- Orthopedics Department, China-Japan Friendship Hospital, Beijing, China
| | - Feng Yang
- Orthopedics Department, China-Japan Friendship Hospital, Beijing, China
| | - Xiangsheng Tang
- Orthopedics Department, China-Japan Friendship Hospital, Beijing, China
| | - Qingying Hao
- Orthopedics Department, China-Japan Friendship Hospital, Beijing, China
| | - Wenhao Li
- Orthopedics Department, China-Japan Friendship Hospital, Beijing, China.,Graduate School of Beijing University of Chinese Medicine, Beijing, China
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Guan J, Song S, Wang W, Ji X, Meng R. Cerebral venous sinus thrombosis due to external compression of internal jugular vein. J Int Med Res 2021; 49:3000605211006609. [PMID: 33845597 PMCID: PMC8047086 DOI: 10.1177/03000605211006609] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Cerebral venous sinus thrombosis (CVST) is a special subtype of stroke that may be life-threatening in severe cases. CVST has distinct risk factors and is frequently overlooked because of its initially nonspecific clinical presentation. We herein describe a 72-year-old man who developed CVST in the right lateral sinus. Despite the absence of common risk factors in this patient, he developed external compression of the bilateral internal jugular veins by a lateral mass of the C1 vertebra and expansion of the carotid artery. Because of his elevated D-dimer and fibrinogen concentrations, which are associated with ongoing activation of the coagulation system, the patient underwent treatment with batroxobin combined with anticoagulation. Recanalization of the sinus was achieved, and his high intracranial pressure and papilledema remarkably decreased. We conclude that external compression of the internal jugular veins, which can be identified with three-dimensional computed tomography venography, may be an important risk factor for CVST.
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Affiliation(s)
- Jingwei Guan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Siying Song
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wei Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xunming Ji
- Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ran Meng
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
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15
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Zou L, Zhong C, Xu X, Liu F, Wang C, Shi B. Effect of Baduanjin exercise on cervical spondylosis: A protocol for the systematic review of randomized controlled trials. Medicine (Baltimore) 2021; 100:e24813. [PMID: 33761641 PMCID: PMC9282061 DOI: 10.1097/md.0000000000024813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 01/29/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The study aims to evaluate the effectiveness and safety of Baduanjin exercise for patients with cervical spondylosis (CS). METHODS We will retrieve a randomized controlled trial of Baduanjin for CS from the following electronic databases establishment to May 2021: The Cochrane Library, MEDLINE, EMBASE, Web of Science, Springer, World Health Organization International Clinical Trials Registry Platform (ICTRP), China National Knowledge Infrastructure (CNKI), Wan-fang database, Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Databases (CBM), and other databases. Two independent researchers will operate article retrieval, duplication removing, screening, quality evaluation, and data analyses by Review Manager (V.5.3.5). Meta-analyses, subgroup analysis, and/or descriptive analysis will be performed based on the included data conditions. RESULTS The results of this study will provide researchers in the field of CS with a current synthesis of high-quality evidence. CONCLUSION This conclusion of this study will provide the evidence of whether Baduanjin is an effective and safe intervention for patients with CS. PROSPERO REGISTRATION NUMBER CRD42020211019.
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Affiliation(s)
- Liang Zou
- School of Acupuncture-Tuina, Shandong University of Traditional Chinese Medicine
- Affiliated Hospital of Back and Neck Pain, Shandong First Medical University
| | - Chongfu Zhong
- The First Affiliated Hospital of Shandong University of Chinese Medicine, Jinan, Shandong, China
| | - Xiaohui Xu
- Affiliated Hospital of Back and Neck Pain, Shandong First Medical University
| | - Fanjie Liu
- Affiliated Hospital of Back and Neck Pain, Shandong First Medical University
| | - Congan Wang
- Affiliated Hospital of Back and Neck Pain, Shandong First Medical University
| | - Bin Shi
- Affiliated Hospital of Back and Neck Pain, Shandong First Medical University
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16
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Cheng YF, Xirasagar S, Yang TH, Wu CS, Kuo NW, Lin HC. A population-based case-control study of the association between cervical spondylosis and tinnitus. Int J Audiol 2021; 60:227-231. [PMID: 32930015 DOI: 10.1080/14992027.2020.1817996] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This population-based study aimed to study the association between tinnitus and cervical spondylosis. DESIGN A case-control study. STUDY SAMPLE We retrieved data from the Taiwan Longitudinal Health Insurance Database. We identified 2465 patients with tinnitus (cases) and 7395 comparison patients by propensity score matching. Multivariable logistic regressions were conducted to estimate the odds (OR) of a diagnosis of cervical spondylosis preceding the tinnitus diagnosis relative to controls. RESULTS We found that 1596 (16.19%) of 9860 sample patients had received a diagnosis of cervical spondylosis before the index date, significantly different between the tinnitus group and control group (17.20% vs. 15.85%, p < 0.001). Logistic regression analysis showed an adjusted OR for prior cervical spondylosis of 1.235 for cases vs. controls (95% confidence interval [CI]: 1.088-1.402). Further, the adjusted ORs were 1.246 (95% CI: 1.041-1.491) and 1.356 (95% CI: 1.016-1.811), respectively, among patients aged 45 ∼ 64 and >64 groups. No difference in cervical spondylosis likelihood between cases and controls was found among patients aged 18 ∼ 44 groups. CONCLUSIONS In conclusion, the study shows a positive association between cervical spondylosis and tinnitus. The findings call for greater awareness among physicians about a possible somatosensory component of cervical spine function which may contribute to tinnitus.
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Affiliation(s)
- Yen-Fu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sudha Xirasagar
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Tzong-Hann Yang
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, Taiwan
- Department of Speech Language Pathology and Audiology, National Taipei University of Nursing Health Sciences, Taipei, Taiwan
| | - Chuan-Song Wu
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, Taiwan
| | - Nai-Wen Kuo
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Herng-Ching Lin
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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17
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Zhuang L, Wang L, Xu D, Wang Z, Liang R. Association between excessive smartphone use and cervical disc degeneration in young patients suffering from chronic neck pain. J Orthop Sci 2021; 26:110-115. [PMID: 32205018 DOI: 10.1016/j.jos.2020.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/29/2020] [Accepted: 02/09/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND With the popularity of smartphones, cervical spondylosis is becoming more and more common among young people. The aim of this study was to investigate the association between excessive smartphone use and cervical disc degeneration in young patients suffering from chronic neck pain. METHODS A total of 2438 young patients suffering from chronic neck pain were included into this study. All patients underwent the Magnetic Resonance Imaging (MRI) examination of the cervical spine. The degree of cervical disc degeneration, the dependent variable, was evaluated by Cervical Disc Degeneration Scale (CDDS) which was developed from Pfirrmann classification. Smartphone use, the primary independent variable, was assessed by Smartphone Addiction Scale (SAS). RESULTS In all, 52.9% patients were categorized as smartphone overuse. Patients with overuse of smartphones had higher CDDS scores than those who did not use smartphone excessively. CONCLUSIONS The results indicate that cervical disc degeneration may be associated with excessive smartphone use, such use may lead to cervical spondylosis.
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Affiliation(s)
- Linbo Zhuang
- Department of Orthopedics, Baoan Central Hospital of Shenzhen, The Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518102, China.
| | - Lisheng Wang
- Department of Orthopedics, Baoan Central Hospital of Shenzhen, The Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518102, China.
| | - Dongming Xu
- Department of Orthopedics, Baoan Central Hospital of Shenzhen, The Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518102, China.
| | - Zhiyong Wang
- Department of Orthopedics, Baoan Central Hospital of Shenzhen, The Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518102, China.
| | - Renzheng Liang
- Department of Orthopedics, Baoan Central Hospital of Shenzhen, The Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518102, China.
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18
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Lee JK, Ham CH, Kwon WK, Moon HJ, Kim JH, Park YK. A New Classification for Cervical Ossification of the Posterior Longitudinal Ligament Based on the Coexistence of Segmental Disc Degeneration. J Korean Neurosurg Soc 2020; 64:69-77. [PMID: 33105534 PMCID: PMC7819796 DOI: 10.3340/jkns.2020.0080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/09/2020] [Indexed: 11/27/2022] Open
Abstract
Objective Classification systems for cervical ossification of the posterior longitudinal ligament (OPLL) have traditionally focused on the morphological characteristics of ossification. Although the classification describes many clinical features associated with the shape of the ossification, including the concept of spondylosis seems necessary because of the similarity in age distribution.
Methods Patients diagnosed with OPLL who presented with increase signal intensity (ISI) on magnetic resonance imaging were surgically treated in our department. The patients were divided into two groups (pure versus degenerative) according to the presence of disc degeneration.
Results Of 141 patients enrolled in this study, more than half (61%) were classified into the degenerative group. The pure group showed a profound male predominance, early presentation of myelopathy, and a different predilection for ISI compared to the degenerative group. The mean canal compromise ratio (CC) of the ISI was 47% in the degenerative group versus 61% in the pure group (p<0.0000). On the contrary, the global and segment motions were significantly larger in the degenerative group (p<0.0000 and p=0.003, respectively). The canal diameters and global angles did not differ between groups.
Conclusion Classifying cervical OPLL based on the presence of combined disc degeneration is beneficial for understanding the disorder’s behavior. CC appears to be the main factor in the development of myelopathy in the pure group, whereas additional dynamic factors appear to affect its development in the degenerative group.
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Affiliation(s)
- Jun Ki Lee
- Department of Neurosurgery, Korea University Guro Hospital, Seoul, Korea
| | - Chang Hwa Ham
- Department of Neurosurgery, Korea University Guro Hospital, Seoul, Korea
| | - Woo-Keun Kwon
- Department of Neurosurgery, Korea University Guro Hospital, Seoul, Korea
| | - Hong Joo Moon
- Department of Neurosurgery, Korea University Guro Hospital, Seoul, Korea
| | - Joo Han Kim
- Department of Neurosurgery, Korea University Guro Hospital, Seoul, Korea
| | - Youn-Kwan Park
- Department of Neurosurgery, Korea University Guro Hospital, Seoul, Korea
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19
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Affiliation(s)
- Nicholas Theodore
- From the Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore
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20
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Neural Cell Adhesion Molecule (NCAM) a Serum Biomarker Indicative for the Severity of Cervical Spondylotic Myelopathy. Clin Spine Surg 2020; 33:E178-E184. [PMID: 32039991 DOI: 10.1097/bsd.0000000000000952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
STUDY DESIGN Peripheral blood samples were obtained from 25 patients with cervical spondylotic myelopathy (CSM) and 13 healthy volunteers. OBJECTIVES Our aim was to investigate the significance of neurodegenerative biomarkers in patients with CSM and correlate their expression with CSM severity. SUMMARY OF BACKGROUND DATA CSM is a common disorder involving chronic progressive compression of the cervical spinal resulting in progressive neurological impairment that ranges from mild tingling in the upper limbs to complete quadriplegia. However, the immunological background related to the neurodegenerative damage and its significance in CSM is still unclear. METHODS Protein expression profiles of 14 neurodegenerative biomarkers were measured by multiplex Luminex bead assay and further analyzed by group comparison statistics, correlation studies, and receiver-operating characteristic analysis. RESULTS Eleven of 14 biomarkers were significantly elevated in CSM patients as compared with healthy subjects (P<0.05). Specifically, the clinical severity of CSM on the scales of Nurick and modified Japanese Orthopedics Association scale (mJOA) was inversely related to neural cell adhesion molecule (NCAM) levels (r=-0.529, P=0.007; r=-0.519, P=0.001, respectively). CONCLUSIONS Serum level of neural cell adhesion molecule may serve as a diagnostic biomarker correlating with the severity of CSM.
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21
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Ahmed SB, Qamar A, Imram M, Fahim MF. Comparison of neck length, relative neck length and height with incidence of cervical spondylosis. Pak J Med Sci 2020; 36:219-223. [PMID: 32063963 PMCID: PMC6994911 DOI: 10.12669/pjms.36.2.832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Objective: To compare the neck length, relative neck length and height between patients with cervical spondylosis and healthy subjects. Methods: This case control study was conducted at Patel hospital, Karachi after the ethical approval of Bahria University Medical and Dental College (BUMDC) and Patel hospital from September 2018 - February 2019. It enrolled eighty eight cases of cervical spondylosis and eighty eight healthy subjects. Radiographs were taken in the lateral view and neck length was measured as the distance from external occipital protuberance to seventh cervical vertebra spinous process. Then relative neck length was measured by dividing the neck length with height and multiplying it by 100. The Kellgren Lawrence grade scale was used to assess the severity of cervical spondylosis. Results: A total of 176 participants were analyzed. It was found that the height remains the significant determinant. The comparison of cases with control group was done using independent T-test which showed that the cases were significantly shorter than controls with a p-value < 0.05. The other variables such as neck length, and relative neck length were insignificant. Conclusion: Short height can be considered as a risk factor for cervical spondylosis. Short-statured individuals should be counseled to adopt measures for the prevention of cervical spondylosis.
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Affiliation(s)
| | - Aisha Qamar
- Prof. Dr. Aisha Qamar, MBBS, M.Phil Anatomy. Department of Anatomy, Bahria University Medical and Dental College, DHA Phase-II, Karachi, Pakistan
| | - Muhammad Imram
- Dr. Muhammad Imran, MBBS, FCPS. HOD Department of Radiology, Patel Hospital, Karachi, Pakistan
| | - Muhammad Faisal Fahim
- Muhammad Faisal Fahim, M.Sc (Statistics), Researcher and Consultant Statistician, Bahria University Medical and Dental College, DHA Phase-II, Karachi, Pakistan
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Huang R, Huang Y, Huang R, Huang S, Wang X, Yu X, Xu D, Chen X. Thunder-Fire Moxibustion for Cervical Spondylosis: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2020; 2020:5816717. [PMID: 32148545 PMCID: PMC7036136 DOI: 10.1155/2020/5816717] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/26/2019] [Accepted: 11/19/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cervical spondylosis (CS) refers to the degenerative changes in the cervical spinal column, which affect the majority of middle-aged and elderly people. Thunder-fire moxibustion originated from thunder-fire miraculous needle, which has been applied widely for treating pain syndromes for thousands of years. The aim of our research is to provide evidence to assess the efficacy and safety of thunder-fire moxibustion in treating CS. Methods and analysis. Retrieved literature databases included Cochrane Library, MEDLINE, Web of Science, EBSCO, EBASE, Springer, PubMed, WFDP, CNKI, VIP, and CBM. The period of retrieval was from the establishment of the database to December 2018. Randomized controlled trials which compared thunder-fire moxibustion and other therapies in CS were included. The quality of inclusive trials was accessed though a Cochrane risk of bias tool. According to the test results of heterogeneity, a random effect model or fixed effect model was used to analyze the data. RESULTS Meta-analysis was conducted for the total effective rate of thunder-fire moxibustion, traditional Chinese medicine syndrome score, pain score, satisfaction score, and score of the symptoms and functional rehabilitation of cervical vertigo. The analysis results were as follows: compared with other therapies, the efficacy of thunder-fire moxibustion was statistically significant, total effective rate increased (OR = 2.48; 95% CI [1.80, 3.41]; P < 0.00001), traditional Chinese medicine syndrome score decreased (SMD = -3.05; 95% CI[-4.18, -1.93]; P < 0.00001), traditional Chinese medicine syndrome score decreased (SMD = -3.05; 95% CI[-4.18, -1.93]; P < 0.00001), traditional Chinese medicine syndrome score decreased (SMD = -3.05; 95% CI[-4.18, -1.93]; P < 0.00001), traditional Chinese medicine syndrome score decreased (SMD = -3.05; 95% CI[-4.18, -1.93]; P < 0.00001), traditional Chinese medicine syndrome score decreased (SMD = -3.05; 95% CI[-4.18, -1.93]. CONCLUSION Based on the existing evidence, the curative effect and safety of thunder-fire moxibustion on CS were statistically significant. We should interpret the results scrupulously because of the low evidence level. Large-scale, high-quality, rigorous RCTs with long-term follow-up should be performed in the future.
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Affiliation(s)
- Ruina Huang
- The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Yunxuan Huang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ruijia Huang
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Shaofen Huang
- Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Xiaojun Wang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaojiang Yu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Danghan Xu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinghua Chen
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Gupta J, Bawaskar R, Rao P, Shivadikar A, Sumithran P, Pal R, Ali S, Bindu H, Arya MD, Lamba C, Kumar A, Kulshreshtha D. Homoeopathic therapy in cervical spondylosis pain management: A randomised, double-blind, placebo-controlled trial. INDIAN JOURNAL OF RESEARCH IN HOMOEOPATHY 2020. [DOI: 10.4103/ijrh.ijrh_70_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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24
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Zhou C, Wang H, Wang C, Tsai TY, Yu Y, Ostergaard P, Li G, Cha T. Intervertebral range of motion characteristics of normal cervical spinal segments (C0-T1) during in vivo neck motions. J Biomech 2019; 98:109418. [PMID: 31653508 DOI: 10.1016/j.jbiomech.2019.109418] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/24/2019] [Accepted: 10/13/2019] [Indexed: 01/19/2023]
Abstract
The in vivo intervertebral range of motion (ROM) is an important predictor for spinal disorders. While the subaxial cervical spine has been extensively studied, the motion characteristics of the occipito-atlantal (C0-1) and atlanto-axial (C1-2) cervical segments were less reported due to technical difficulties in accurate imaging of these two segments. In this study, we investigated the intervertebral ROMs of the entire cervical spine (C0-T1) during in vivo functional neck motions of asymptomatic human subjects, including maximal flexion-extension, left-right lateral bending, and left-right axial torsion, using previously validated dual fluoroscopic imaging and model registration techniques. During all neck motions, C0-1, similar to C7-T1, was substantially less mobile than other segments and always contributed less than 10% of the cervical rotations. During the axial rotation of the neck, C1-2 contributed 73.2 ± 17.3% of the cervical rotation, but each of other segments contributed less than 10% of the cervical rotation. During both lateral bending and axial torsion neck motions, regardless of primary or coupled motions, the axial torsion ROM of C1-2 was significantly greater than its lateral bending ROM (p < 0.001), whereas the opposite differences were consistently observed at subaxial segments. This study reveals that there are distinct motion patterns at upper and lower cervical segments during in vivo neck motions. The reported data could be useful for the development of new diagnosis methods of cervical pathologies and new surgical techniques that aim to restore normal cervical segmental motion.
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Affiliation(s)
- Chaochao Zhou
- Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Harvard Medical School, Newton, MA, USA; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Haiming Wang
- Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Harvard Medical School, Newton, MA, USA; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Cong Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Tsung-Yuan Tsai
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
| | - Yan Yu
- Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Harvard Medical School, Newton, MA, USA; Department of Spine Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Peter Ostergaard
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Guoan Li
- Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Harvard Medical School, Newton, MA, USA.
| | - Thomas Cha
- Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Harvard Medical School, Newton, MA, USA; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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25
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Shatri J, Kukaj V. Role of MRI in Cervical Spondylotic Myelopathy with Other Pathological Findings: Case Report and Literature Review. Acta Inform Med 2019; 27:139-142. [PMID: 31452574 PMCID: PMC6688289 DOI: 10.5455/aim.2019.27.139-142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Introduction Cervical spondylotic myelopathy (CSM) is a neck condition that arises when the spinal cord becomes compressed due to the wear-and-tear changes that occur in the spine as we age. Case report The patient was a 52-year-old male, who complains of neck pain, paranesthesia in upper extremities, lower back pain and bilateral calf pain, muscle weakness in the lower and upper extremities, fatigue and general body pain that started four weeks ago associated with other clinical manifestation. Magnetic Resonance Imaging (MRI) of the cervical spine revealed canal stenosis and increased T2 signal within the spinal cord. CSM is a rare condition there are very few or no cases described in literature when CSM in C3/C4 is associated with a lack of B12 and other pathologies such as and hypoplasia of the mastoid air-cell with system maxillary sinus aplasia. Conclusion The case described in the present study suggested that the incidence of CSM may be correlated with VB12 deficiency, particularly for cases in which the clinical manifestations and the imaging do not fully match.
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Affiliation(s)
- Jeton Shatri
- Department of Radiology, Diagnostic Center, University Clinical Center of Kosovo, Prishtina. Kosovo.,Department of Anatomy, Faculty of Medicine, University of Prishtina "Hasan Prishtina", Prishtina. Kosovo
| | - Vera Kukaj
- Department of Neurology, Diagnostic Center, University Clinical Center of Kosovo, Prishtina. Kosovo
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26
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Rydman E, Bankler S, Ponzer S, Järnbert-Pettersson H. Quantifying cervical spondylosis: reliability testing of a coherent CT-based scoring system. BMC Med Imaging 2019; 19:45. [PMID: 31146696 PMCID: PMC6543559 DOI: 10.1186/s12880-019-0342-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 05/21/2019] [Indexed: 01/27/2023] Open
Abstract
Background Grading of degeneration of the cervical spine is of great clinical value, considering the vast amount of radiological investigations that are being done with this query. Despite the fact that Computed Tomography (CT) is frequently used in clinical practice there is today no user-friendly and reliable scoring system for assessment of cervical spondylosis on CT-scans available. The aim of this study was to establish a scoring system for cervical spondylosis based on CT-scans and to test it for reliability. Methods Twenty adult patients undergoing CT of the cervical spine due to neck pain following a motor vehicle accident were included in the study. Three independent raters, i.e. one orthopedic surgeon and two radiologists, assessed their CT-scans. Two of the raters repeated the assessments after three months. A radiographic-based scoring system for cervical disc degeneration, addressing disc height, osteophytes and endplate sclerosis, was applied on CT and tested for reliability. A pre-existing, reliable CT-based scoring system for facet joint degeneration, considering joint space narrowing, osteophytes and irregularity of the articular surface was modified and reevaluated. This in order to develop a coherent CT-based total degeneration score for cervical spondylosis. Results The scoring systems for cervical disc degeneration and facet joint degeneration both exhibited an acceptable or better level of strength of agreement regarding intra- and interrater agreement. The total disc degeneration score showed a moderate level of inter-rater reliability with a kappa-value of 0.47 and a good intra-rater agreement with intra-class correlation coefficients (ICC) of 0.67 and 0.60 for the two raters performing the assessments. The total facet joint degeneration score showed a moderate level of inter-rater reliability (kappa 0.54) and an excellent intra-rater agreement with ICC 0.75 for one of the raters and fair for the other rater (ICC 0.54). When the total disc and facet joint degeneration score were classified into a three-point total degeneration score the inter-rater agreement was 0.695 and the ICC 0.82 and 0.73 respectively. Conclusions This coherent scoring system assessing both disc degeneration and facet joint degeneration on CT-scans of the cervical spine was shown to meet the standards of reliability.
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Affiliation(s)
- Eric Rydman
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. .,Department of Orthopedics, Södersjukhuset, SE-118 83, Stockholm, Sweden.
| | - Sara Bankler
- Department of Radiology, Södersjukhuset, Stockholm, Sweden
| | - Sari Ponzer
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Hans Järnbert-Pettersson
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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27
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Ding JY, Zhou D, Pan LQ, Ya JY, Liu C, Yan F, Fan CQ, Ding YC, Ji XM, Meng R. Cervical spondylotic internal jugular venous compression syndrome. CNS Neurosci Ther 2019; 26:47-54. [PMID: 31119898 PMCID: PMC6930831 DOI: 10.1111/cns.13148] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/17/2019] [Accepted: 04/21/2019] [Indexed: 12/11/2022] Open
Abstract
Aims This study aimed to identify the clinical profiles of cervical spondylosis‐related internal jugular vein stenosis (IJVS) comprehensively. Methods A total of 46 patients, who were diagnosed as IJVS induced by cervical spondylotic compression were recruited. The clinical manifestations and imaging features of IJVS were presented particularly in this study. Results Vascular stenosis was present in 69 out of the 92 internal jugular veins, in which, 50.7% (35/69) of the stenotic vessels were compressed by the transverse process of C1, and 44.9% (31/69) by the transverse process of C1 combined with the styloid process. The transverse process of C1 compression was more common in unilateral IJVS (69.6% vs 41.3%, P = 0.027) while the transverse process of C1 combined with the styloid process compression had a higher propensity to occur in bilateral IJVS (52.2% vs 30.4%, P = 0.087). A representative case underwent the resection of the elongated left lateral mass of C1 and styloid process. His symptoms were ameliorated obviously at 6‐month follow‐up. Conclusions This study proposes cervical spondylotic internal jugular venous compression syndrome as a brand‐new cervical spondylotic subtype. A better understanding of this disease entity can be of great relevance to clinicians in making a proper diagnosis.
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Affiliation(s)
- Jia-Yue Ding
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Da Zhou
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li-Qun Pan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing-Yuan Ya
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Cheng Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Yongxin People's Hospital, Ji'an, China
| | - Feng Yan
- Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Chun-Qiu Fan
- Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu-Chuan Ding
- Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan
| | - Xun-Ming Ji
- Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ran Meng
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
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28
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Association of Depression and Cervical Spondylosis: A Nationwide Retrospective Propensity Score-Matched Cohort Study. J Clin Med 2018; 7:jcm7110387. [PMID: 30366474 PMCID: PMC6262285 DOI: 10.3390/jcm7110387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/20/2018] [Accepted: 10/23/2018] [Indexed: 01/12/2023] Open
Abstract
Objective: Depression is a psychiatric disorder associated with poorer health outcomes. Inappropriate mechanical stress and aging are factors associated with developing cervical spondylosis. The connection between cervical spondylosis and depression is not developed. Methods: From the health insurance claims data of Taiwan, we identified 34,166 persons newly diagnosed with depression in 2000⁻2010 and 34,166 persons without the disorder frequency matched by sex, age and diagnosis year. Both cohorts were followed up to the end of 2013 to estimate incident cervical spondylosis. We further examined the risk of cervical spondylosis in depressed people taking antidepressants. Results: The incidence of cervical spondylosis was 1.8-fold greater in the depression cohort than in comparison cohort (9.46 vs. 5.36 per 1000 person-years), with an adjusted hazard ratio (aHR) of 1.79 (95% confidence interval (CI) = 1.66⁻1.92). The incidence of cervical spondylosis increased in patients who had taken medications of serotonin-specific reuptake inhibitors (SSRIs) or of non-SSRIs than in those without these medicines (9.13 or 11.5 vs. 6.54 per 1000 person-years, respectively). Conclusions: Patients with depression are at an increased risk of developing cervical spondylosis. Additional efforts in reducing the risk of cervical spondylosis might be required in depressed individuals undergoing anti-depressive therapy.
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Lv Y, Tian W, Chen D, Liu Y, Wang L, Duan F. The prevalence and associated factors of symptomatic cervical Spondylosis in Chinese adults: a community-based cross-sectional study. BMC Musculoskelet Disord 2018; 19:325. [PMID: 30205836 PMCID: PMC6134586 DOI: 10.1186/s12891-018-2234-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 08/16/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cervical spondylosis adversely affects life quality for its heavy disease burden. The report on the community-based prevalence and associated factors of cervical spondylosis is rare, especially in Chinese population. Whether prevention is needed and how to prevent it is not clear. This study aims to explore its prevalence and related lifestyle factors and provide evidence on prevention of cervical spondylosis. METHODS A community-based multistage cross-sectional survey of six communities from the Chinese population was conducted. A face-to-face interview was conducted to obtain individual information, and prevalence was calculated. Single-factor analysis and multivariable logistic regressions were used to explore the associated factors in total and subgroup populations. RESULTS A total of 3859 adults were analyzed. The prevalence of cervical spondylosis was 13.76%, although it differed significantly among the urban, suburban, and rural populations (13.07%, 15.97%, and 12.25%, respectively). Moreover, it was higher in females than in males (16.51% vs 10.49%). The prevalence among different age groups had an inverted U shape. The highest prevalence was in the age group from 45 to 60 years old. The associated factors differed by subgroups. There were positive associations between engaging in mental work, high housework intensity, and sleep duration of less than 7 h/day with cervical spondylosis. Going to work on foot was a negative factor of cervical spondylosis in the total population. For people aged less than 30 years, keeping the same work posture for 1-2.9 h/day was a special related factor. Exposure to vibration was an associated factor for females aged 45-60 years. Menopause was a special related factor for women. CONCLUSIONS Prevalence of cervical spondylosis was high in Chinese population. People younger than 60 years were the focus of prevention for cervical spondylosis. Moreover, the characters between male and female and among different age groups were different and required targeted interventions.
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Affiliation(s)
- Yanwei Lv
- Department of Epidemiology and Biostatistics, Public Health College, Peking University, 38# Xueyuan Road, Haidian district, Beijing, 100191, China.,Clinical Epidemiology Research Center, Beijing Jishuitan Hospital, 31# Xinjiekou Dongjie, West district, Beijing, 100035, China.,Department of Spine, Beijing Jishuitan Hospital, 31# Xinjiekou Dongjie, West district, Beijing, 100035, China
| | - Wei Tian
- Clinical Epidemiology Research Center, Beijing Jishuitan Hospital, 31# Xinjiekou Dongjie, West district, Beijing, 100035, China. .,Department of Spine, Beijing Jishuitan Hospital, 31# Xinjiekou Dongjie, West district, Beijing, 100035, China.
| | - Dafang Chen
- Department of Epidemiology and Biostatistics, Public Health College, Peking University, 38# Xueyuan Road, Haidian district, Beijing, 100191, China.
| | - Yajun Liu
- Department of Spine, Beijing Jishuitan Hospital, 31# Xinjiekou Dongjie, West district, Beijing, 100035, China
| | - Lifang Wang
- Clinical Epidemiology Research Center, Beijing Jishuitan Hospital, 31# Xinjiekou Dongjie, West district, Beijing, 100035, China
| | - Fangfang Duan
- Clinical Epidemiology Research Center, Beijing Jishuitan Hospital, 31# Xinjiekou Dongjie, West district, Beijing, 100035, China
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A preliminary study: The effect of ergonomic latex pillow on pain and disability in patients with cervical spondylosis. Med J Islam Repub Iran 2018; 32:81. [PMID: 30643756 PMCID: PMC6325275 DOI: 10.14196/mjiri.32.81] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Indexed: 11/20/2022] Open
Abstract
Background: Cervical pillows are considered to be part of the therapeutic strategy in cervical spondylosis, but there is little or no convincing scientific evidence on the effectiveness of these pillows in relieving pain and disability in these patients. Hence, this study investigated the effects of ergonomic latex pillow in conjunction with routine physiotherapy versus routine physiotherapy alone on disability and pain intensity in patients with cervical spondylosis.
Methods: 22 patients with cervical spondylosis in a single-blinded pilot study with a pre/post-test design were randomly assigned to experimental and control groups. Both groups received 12 sessions of physiotherapy for four weeks. In the experimental group, participants were given an ergonomic latex pillow to sleep it for four weeks. Participants in the control group slept on their own usual pillow. All the participants filled out the Neck Disability Index questionnaire, and scored their neck pain intensity on the Numerical Pain Rating Scale before and after the intervention. Changes of variables (pain and disability) within and between groups were compared by Paired T-test and the Independent Sample T-test, respectively via SPSS v.20 (p<0.05).
Results: Numerical Pain Rating Scale and Neck Disability Index scores were decreased statistically significant within groups. In the experimental group, neck disability scores were significantly lower than those in the control group (p=0.038). However, pain intensity scores were not significantly different between groups.
Conclusion: Ergonomic latex pillows can significantly decrease disability related to neck pain in patients with cervical spondylosis after four weeks.
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31
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Tykocki T, du Plessis J, Wynne-Jones G. Correlation between the severity of myelopathy and cervical morphometric parameters on dynamic magnetic resonance imaging. Acta Neurochir (Wien) 2018; 160:1251-1258. [PMID: 29687255 DOI: 10.1007/s00701-018-3540-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 04/04/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND To compare morphometric factors of cervical spine in the cervical stenosis on dynamic and static magnetic resonance imaging. To analyse the relationship between the severity of myelopathy and morphometric parameters. METHODS Patients with cervical canal stenosis scanned with MRI in neutral (N), flexion (F) and extension (E) positions were retrospectively reviewed. All cases were evaluated in Nurick and Muhle grades. Following parameters were measured: anterior and posterior length of the cervical cord (aLCC, pLCC), mid-cord distance (L value), cervical cord angle (CCA), cervical lordosis, spine/cord (S/C) angle ratio, spinal cord (SC) area, cerebrospinal fluid (CSF) area, and CSF reserve ratio (CSF/CSF plus SC). Univariate multiple regression for Nurick grade as dependent factor was used. RESULTS Sixty-three patients and 34 men, with the mean age of 58.2 ± 11 years, were analysed. Significant differences were found for pLCC, SC area, C lordosis and CCA. The difference between F and E for C lordosis angle was 42.80° ± 14.4 and for CC angle 30.42° ± 9.6. The mean S/C angle ratio was calculated for 1.4 ± 1.3. Nurick grade positively correlated with age (p = 0.041) and S/C angle ratio (p = 0.011), negatively with SC area (p = 0.006) and flexion-extension difference of L value (0.004). CONCLUSIONS Severity of myelopathy correlates with age, spinal cord area on extension and reduced mobility of spinal cord. An association between spine/cervical cord angle mismatch and Nurick grade was found.
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Affiliation(s)
- Tomasz Tykocki
- Department of Musculoskeletal, Spinal Unit, Royal Victoria Infirmary, Queen Victoria Rd, Newcastle upon Tyne, NE1 4LP, UK.
| | - Johannes du Plessis
- Department of Neuroradiology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Guy Wynne-Jones
- Department of Musculoskeletal, Spinal Unit, Royal Victoria Infirmary, Queen Victoria Rd, Newcastle upon Tyne, NE1 4LP, UK
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Grisdela P, Buser Z, D'Oro A, Paholpak P, Liu JC, Wang JC. Trends analysis of surgical procedures for cervical degenerative disc disease and myelopathy in patients with tobacco use disorder. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 26:2386-2392. [PMID: 28488093 DOI: 10.1007/s00586-017-5120-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 04/04/2017] [Accepted: 05/02/2017] [Indexed: 01/13/2023]
Abstract
PURPOSE This study defined the incidence and trends of surgeries performed for patients with cervical disc degeneration with and without tobacco use disorder (TUD). METHODS This study utilized the Humana Inc. database between 2007 and 2013 to identify patients with cervical disc degeneration with or without myelopathy. International Classification of Diseases, ninth revision (ICD-9) and Current Procedural Terminology (CPT) codes determined the initial diagnosis of disc degeneration, myelopathy status and TUD, whether patients received surgery, and TUD status at surgery. RESULTS The prevalence of disc degeneration with myelopathy increased by 32.8% between 2007 and 2013, while disc disease with myelopathy and TUD increased by 91.6%. For patients without myelopathy, the prevalence of disc degeneration alone increased by 65.4%, and disc degeneration with myelopathy increased by 148.7%. Of myelopathy patients, 1717 (6.4%) had TUD and 1024 (59.6%) received surgery, compared to 6508 patients without TUD (26.1%). For patients without myelopathy, 11,337 (3.5%) had TUD and 787 (6.9%) underwent surgery, compared to 9716 patients (3%) without TUD. Of surgical patients, 781 (76.3%) with myelopathy and TUD still had a TUD diagnosis at surgery, and 542 (68.9%) of patients without myelopathy still had a TUD diagnosis at surgery. CONCLUSIONS The prevalence of degenerative disc disease and TUD has increased more than disc disease alone. Patients with TUD were more likely to get surgery, and to have surgeries earlier than patients without TUD. Patients with TUD at the time of the diagnosis of their disc degeneration likely still had a TUD diagnosis at the time of surgery.
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Affiliation(s)
- Phillip Grisdela
- Department of Orthopaedic Surgery, Keck School of Medicine, Elaine Stevely Hoffman Medical Research Center, University of Southern California, 2011 Zonal Ave., HMR 710, Los Angeles, CA, 90033, USA
| | - Zorica Buser
- Department of Orthopaedic Surgery, Keck School of Medicine, Elaine Stevely Hoffman Medical Research Center, University of Southern California, 2011 Zonal Ave., HMR 710, Los Angeles, CA, 90033, USA.
| | - Anthony D'Oro
- Department of Orthopaedic Surgery, Keck School of Medicine, Elaine Stevely Hoffman Medical Research Center, University of Southern California, 2011 Zonal Ave., HMR 710, Los Angeles, CA, 90033, USA
| | - Permsak Paholpak
- Department of Orthopaedic Surgery, Keck School of Medicine, Elaine Stevely Hoffman Medical Research Center, University of Southern California, 2011 Zonal Ave., HMR 710, Los Angeles, CA, 90033, USA
| | - John C Liu
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Jeffrey C Wang
- Department of Orthopaedic Surgery, Keck School of Medicine, Elaine Stevely Hoffman Medical Research Center, University of Southern California, 2011 Zonal Ave., HMR 710, Los Angeles, CA, 90033, USA
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Kiadaliri AA, Englund M. Mortality with musculoskeletal disorders as underlying cause in Sweden 1997-2013: a time trend aggregate level study. BMC Musculoskelet Disord 2016; 17:163. [PMID: 27075669 PMCID: PMC4831100 DOI: 10.1186/s12891-016-1024-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/09/2016] [Indexed: 12/13/2022] Open
Abstract
Background The aim was to assess time trend of mortality with musculoskeletal disorders (MSD) as underlying cause of death in Sweden from 1997 to 2013. Methods We obtained data on MSD as underlying cause of death across age and sex groups from the National Board of Health and Welfare's Cause of Death Register. Age-standardized mortality rates per million population for all MSD, its six major subgroups, and all other ICD-10 (International Classification of Disease) chapters were calculated. We computed the average annual percent change (AAPC) in the mortality rates across age/sex groups using joinpoint regression analysis by fitting a regression line to the natural logarithm of the age-standardized mortality rates and calendar year as a predictor. Results There were a total of 7 976 deaths (0.5 % of all causes deaths) with MSD as the underlying cause of death (32.5 % of these deaths caused by rheumatoid arthritis [RA]). The overall age-standardized mortality rates (95 % CI) were 16.0 (15.4 to 16.7) and 24.9 (24.1 to 25.7) per million among men and women, respectively (women/men rate ratio 1.55; 95%CI 1.47 to 1.63). On average, mortality rate declined by 2.3 % per year and only circulatory system mortality had a more favourable decline than mortality with MSD as underlying cause. Among MSD the highest decline was observed in RA (3.7 % per year) during study period. Across age groups, while there were generally stable or declining trends, spondylopathies and osteoporosis mortality among people ≥ 75 years increased by 2 and 1.5 % per year, respectively. Conclusion In overall, mortality with MSD as underlying cause has declined in Sweden over last two decades, with the highest decline for RA. However, there are variations across MSD subgroups which warrants further investigations.
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Affiliation(s)
- Aliasghar A Kiadaliri
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden. .,Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. .,Clinical Epidemiology Unit, Skåne University Hospital, Klinikgatan 22, SE-221 85, Lund, Sweden.
| | - Martin Englund
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden.,Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA, USA
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Wang C, Tian F, Zhou Y, He W, Cai Z. The incidence of cervical spondylosis decreases with aging in the elderly, and increases with aging in the young and adult population: a hospital-based clinical analysis. Clin Interv Aging 2016; 11:47-53. [PMID: 26834465 PMCID: PMC4716725 DOI: 10.2147/cia.s93118] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and purpose Cervical spondylosis is well accepted as a common degenerative change in the cervical spine. Compelling evidence has shown that the incidence of cervical spondylosis increases with age. However, the relationship between age and the incidence of cervical spondylosis remains obscure. It is essential to note the relationship between age and the incidence of cervical spondylosis through more and more clinical data. Methods In the case-controlled study reported here, retrospective clinical analysis of 1,276 cases of cervical spondylosis has been conducted. We analyzed the general clinical data, the relationship between age and the incidence of cervical spondylosis, and the relationship between age-related risk factors and the incidence of cervical spondylosis. A chi-square test was used to analyze the associations between different variables. Statistical significance was defined as a P-value of less than 0.05. Results The imaging examination demonstrated the most prominent characteristic features of cervical spondylosis: bulge or herniation at C3-C4, C4-C5, and C5-C6. The incidence of cervical spondylosis increased with aging before age 50 years and decreased with aging after age 50 years, especially in the elderly after 60 years old. The occurrence rate of bulge or herniation at C3-C4, C4-C5, C5-C6, and C6-C7 increased with aging before age 50 years and decreased with aging after age 50 years, especially after 60 years. Moreover, the incidence of hyperosteogeny and spinal stenosis increased with aging before age 60 years and decreased with aging after age 60 years, although there was no obvious change in calcification. The age-related risk factors, such as hypertension, hyperlipidemia, diabetes, cerebral infarct, cardiovascular diseases, smoking, and drinking, have no relationship with the incidence of cervical spondylosis. Conclusion A decreasing proportion of cervical spondylosis with aging occurs in the elderly, while the proportion of cervical spondylosis increases with aging in the young and the adults. This investigation implicates that aging is not only a contributor to the clinical performance of cervical spondylosis in the elderly, although the incidence of cervical spondylosis is proportional to the progress of age.
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Affiliation(s)
- Chuanling Wang
- Department of Neurology, Hubei University of Medicine, Shiyan Renmin Hospital, Shiyan, Hubei Province, People's Republic of China
| | - Fuming Tian
- Department of Neurology, Hubei University of Medicine, Shiyan Renmin Hospital, Shiyan, Hubei Province, People's Republic of China
| | - Yingjun Zhou
- Physical Examination Center, Renmin Hospital, Hubei University of Medicine, Shiyan Renmin Hospital, Shiyan, Hubei Province, People's Republic of China
| | - Wenbo He
- Department of Neurology, Hubei University of Medicine, Shiyan Renmin Hospital, Shiyan, Hubei Province, People's Republic of China
| | - Zhiyou Cai
- Department of Neurology, Hubei University of Medicine, Shiyan Renmin Hospital, Shiyan, Hubei Province, People's Republic of China
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Jay Gaffney C, Ryan Spiker W. Treating multilevel (three or four level) cervical myelopathy with ACDF or ACCF. ACTA ACUST UNITED AC 2014. [DOI: 10.1053/j.semss.2014.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Radl R, Leixner G, Stihsen C, Windhager R. [Spondylarthrosis of the cervical spine. Therapy]. DER ORTHOPADE 2013; 42:785-92; quiz 793-4. [PMID: 23989596 DOI: 10.1007/s00132-013-2153-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Chronic neck pain is often associated with spondylarthrosis, whereby segments C4/C5 (C: cervical) are most frequently affected. Spondylarthrosis can be the sole complaint, but it is associated with a degenerative cascade of the spine. The umbrella term for neck pain is the so-called cervical syndrome, which can be differentiated into segmental dysfunction and/or morphological changes of the intervertebral discs and small joints of the vertebral column. Conservative therapy modalities include physical therapy, subcutaneous application of local anesthetics, muscle, nerve and facet joint injections in addition to adequate analgesic and muscle relaxant therapy. If surgery is required, various techniques via dorsal and ventral approaches, depending on the clinic and morphologic changes, can be applied.
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Affiliation(s)
- R Radl
- Abteilung für Orthopädie und Orthopädische Chirurgie, Allgemeines und Orthopädisches LKH Stolzalpe, Stolzalpe 38, 8852, Stolzalpe, Österreich.
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Yao W, Qiu J, Zhou Z, Zhang L, Zhang C. Cervical spinal cord compression after thyroidectomy under general anesthesia. J Anesth 2013; 28:125-7. [PMID: 23828450 DOI: 10.1007/s00540-013-1667-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 06/18/2013] [Indexed: 11/28/2022]
Abstract
Cervical spinal cord injury is a rare but serious complication after general anesthesia. The risk factors include traumatic cervical injury, cervical spine instability, and difficult airway management. It has also occurred in the absence of cervical instability. Here we report a patient who had a history of intermittent neck pain without numbness. Preoperative radiologic examinations showed degenerative changes in the cervical spine. She developed progressive tingling and numbness in her limbs after thyroidectomy under general anesthesia. Magnetic resonance imaging showed a cervical disc protruding into the canal at C5-C6, which was considered to be induced by surgical positioning. She recovered after anterior cervical decompression and internal fixation surgery.
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Affiliation(s)
- Wenlong Yao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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